Controlling malignant pericardial effusion by intrapericardial administration of recombinant mutant human tumor necrosis factor in patients with carcinoma

Objective: To evaluate the therapeutic efficacy of injecting recombinant mutant human tumor necrosis factor (rmhTNF) into pericardial cavity of carcinoma patients with malignant pericardial effusion. Methods: In 20 cases of malignant pericardial effusion, the intrapericardial catheter was inserted into pericardial cavity, and then rmhTNF of 1.5 × 107 U was infused. The infusion was repeated every 5-7 days with the total 4-6 times. If the effusion disappeared, rmhTNF was then used 2 more times and then the intrapericardial catheter was pulled out. Results: Of 20 patients, 14 were complete response (CR), 4 were partial response (PR) and 2 no change (NC). The disappearance of effusion in 6 cases lasted for more than 6 months. Conclusion: Injecting rmhTNF into pericardial cavity may be a better way to control malignant pericardial effusion and has mild side effects.

Interferon-gamma and tumor necrosis factor-alpha synergistically enhance the immunosuppressive capacity of human umbilical-cordderived mesenchymal stem cells by increasing PD-L1 expression

BACKGROUND The immunosuppressive capacity of mesenchymal stem cells(MSCs)is dependent on the“license”of several proinflammatory factors to express immunosuppressive factors such as programmed cell death 1 ligand 1(PD-L1),which determines the clinical therapeutic efficacy of MSCs for inflammatory or immune diseases.In MSCs,interferon-gamma(IFN-γ)is a key inducer of PD-L1 expression,which is synergistically enhanced by tumor necrosis factor-alpha(TNF-α);however,the underlying mechanism is unclear.AIM To reveal the mechanism of pretreated MSCs express high PD-L1 and explore the application of pretreated MSCs in ulcerative colitis.METHODS We assessed PD-L1 expression in human umbilical-cord-derived MSCs(hUC-MSCs)induced by IFN-γand TNF-α,alone or in combination.Additionally,we performed signal pathway inhibitor experiments as well as RNA interference experiments to elucidate the molecular mechanism by which IFN-γalone or in combination with TNF-αinduces PD-L1 expression.Moreover,we used luciferase reporter gene experiments to verify the binding sites of the transcription factors of each signal transduction pathway to the targeted gene promoters.Finally,we evaluated the immunosuppressive capacity of hUC-MSCs treated with IFN-γand TNF-αin both an in vitro mixed lymphocyte culture assay,and in vivo in mice with dextran sulfate sodium-induced acute colitis.RESULTS Our results suggest that IFN-γinduction alone upregulates PD-L1 expression in hUC-MSCs while TNF-αalone does not,and that the co-induction of IFN-γand TNF-αpromotes higher expression of PD-L1.IFN-γinduces hUCMSCs to express PD-L1,in which IFN-γactivates the JAK/STAT1 signaling pathway,up-regulates the expression of the interferon regulatory factor 1(IRF1)transcription factor,promotes the binding of IRF1 and the PD-L1 gene promoter,and finally promotes PD-L1 mRNA.Although TNF-αalone did not induce PD-L1 expression in hUCMSCs,the addition of TNF-αsignificantly enhanced IFN-γ-induced JAK/STAT1/IRF1 activation.TNF-αupregulated IFN-γreceptor expression through activation of the nuclear factor kappa-B signaling pathway,which significantly enhanced IFN-γsignaling.Finally,co-induced hUC-MSCs have a stronger inhibitory effect on lymphocyte proliferation,and significantly ameliorate weight loss,mucosal damage,inflammatory cell infiltration,and up-regulation of inflammatory factors in colitis mice.CONCLUSION Overall,our results suggest that IFN-γand TNF-αenhance both the immunosuppressive ability of hUC-MSCs and their efficacy in ulcerative colitis by synergistically inducing high expression of PD-L1.

SYNTHESIS AND EXPRESSION OF A GENE FOR HUMAN TUMOR NECROSIS FACTOR-ALPHA (TNF-α)

TNF-α was found originally In sera of Bacillus Calmette Guerln infected mice as a macrophage derived factor. It Is cytotoxlc for tumor cell and less or not toxic to normal cells in vitor. The gene for human TNF-α with E. coli-preferred codons has been designed according to the amino acid sequence deduced from the cDNA. The gene with 504 bp was divided into 27 oligonucleotide fragments having 30. to 40 nucleotides each. The solid phase phosphotriester method was used for the synthesis of these oligonucleotides. The 27 fragments were annealed to three segments and then linked by T4 DNA ligase. The entire gene was incorporated into plasmld PDR540 with Tac promoter which was used to transform E. coli 7118. The expressed protein was estimated by SDSPAGE with a molecular weight of 1. 7×104Da. The cytotoxlc activity of the product against L-929 cell was 1. 0×107units/ml culture.

Protective effect of curcumin on tumor necrosis factor-alpha-induced neuronal damage in the rat hippocampus A relationship to the inhibition of neuronal Ca^(2+) influx

BACKGROUND： Previous studies of curcumin have focused mainly on its cytotoxic properties for antitumor therapy. There are few studies addressing the application of curcumin in the prevention and treatment of nervous system diseases. OBJECTIVE： To observe the protective effect of curcumin against tumor necrosis factor-alpha （TNF-α）-induced neuronal damage in the rat hippocampus and to explore the intervention effect of curcumin on Ca^2＋ influx following neuronal damage. DESIGN, TIME AND SETTING： A cell morphological and physiological study was performed at the Institute of Brain Research, Medical College of Jinan University, China, from December 2006 to June 2007. MATERIALS： Curcumin （Sigma, USA） and TNF-α （Sigma, USA） were used in this study. METHODS： Hippocampal neurons were isolated from one-day neonatal rats and primarily cultured for 5 days. Following this they received 1 pmol/L curcumin and 100 ng/mL TNF-a pre-treatment. Dynamic morphological changes were observed for 1 hour by inverted microscopy. At 48 hours post-treatment, static morphological characteristics of the neurons were observed using inverted microscopy. Subsequently, hippocampal neurons were primarily cultured for 7 days, after receiving 1 pmol/L curcumJn and 4.5 ng/mL TNF-a pre-treatment. Intracellular free Ca^2＋ was measured using Fluo 3/acetoxymethyl ester. MAIN OUTCOME MEASURES： Effects of curcumin on TNF-a-induced neuronal damage and Ca^2＋ influx in the rat hippocampus were measured. RESULTS： Following curcumin treatment, TNF-a-induced neurons grew as normal. TNF-a induced a rapid Ca^2＋ influx into the neuronal cytoplasm; however, Ca2＋ fluorescence intensity only slightly increased when neurons were co-perfused with curcumin and TNF-α. CONCLUSION： Curcumin has a protective effect on rat hippocampal neurons possibly by reducing the TNF-α-induced rapid Ca^2＋ influx into neuronal cytoplasm and by maintaining the Ca^2＋ homeostasis.

Tumor necrosis factor-αinhibition restores matrix formation by human adipose-derived stem cells in the late stage of chondrogenic differentiation

BACKGROUND Cartilage tissue engineering is a promising strategy for treating cartilage damage.Matrix formation by adipose-derived stem cells(ADSCs),which are one type of seed cell used for cartilage tissue engineering,decreases in the late stage of induced chondrogenic differentiation in vitro,which seriously limits research on ADSCs and their application.AIM To improve the chondrogenic differentiation efficiency of ADSCs in vitro,and optimize the existing chondrogenic induction protocol.METHODS Tumor necrosis factor-alpha(TNF-α)inhibitor was added to chondrogenic culture medium,and then Western blotting,enzyme linked immunosorbent assay,immunofluorescence and toluidine blue staining were used to detect the cartilage matrix secretion and the expression of key proteins of nuclear factor kappa-B(NF-κB)signaling pathway.RESULTS In this study,we found that the levels of TNF-αand matrix metalloproteinase 3 were increased during the chondrogenic differentiation of ADSCs.TNF-αthen bound to its receptor and activated the NF-κB pathway,leading to a decrease in cartilage matrix synthesis and secretion.Blocking TNF-αwith its inhibitors etanercept(1μg/mL)or infliximab(10μg/mL)significantly restored matrix formation.CONCLUSION Therefore,this study developed a combination of ADSC therapy and targeted anti-inflammatory drugs to optimize the chondrogenesis of ADSCs,and this approach could be very beneficial for translating ADSC-based approaches to treat cartilage damage.

Effect of tumor necrosis factor-α on ventricular arrhythmias in rats with acute myocardial infarction in vivo

Acute myocardial infarction （AMI） is an acute cardiovascular emergency. This study was undertaken to assess the effect of tumor necrosis factor-a （TNF-a） on ventricular arrhythmias induced byAMI in rats in vivo. Two hundred and forty male Wistar rats were randomized into a sham- operation group, an AMI group, and a recombinant human tumor necrosis factor receptor：Fc fusion protein（rhTNFR：Fc） group. Acute anterior wall myocardial infarction was produced in the AMI group by ligating the left anterior descending coronary artery （LAD）, and there was no ligation but operation in the sham-operation group. The rhTNFR：Fc group was treated with rhTNFR：Fc（10 mg/kg）, a TNF-a antagonist, 24 hours before LAD ligation. The spontaneous and induced programmed electrical stimulation ventricular arrhythmias were recorded at baseline and 10 minutes, 20 minutes, 30 minutes, 60 minutes, 3 hours, 6 hours and 12 hours after ligation. At the same time the protein and mRNA expression levels of TNF-a among different groups were detected by histochemistry and real-time fluorescent quantitative PCR. Expression of TNF-a increased markedly from 10 minutes after infarction, peaked at 20-30 minutes, and returned to baseline gradually in the AMI group and rhTNFR：Fc group. The time- windows of spontaneous and induced ventricular arrhythmias were similar. Compared with the AMI group, the rhTNFR：Fc group showed a lesser expression of TNF-a protein and a lower incidence of ventricular arrhythmias （P〈0.05）. There was no obvious change in the sham-operation group. The expression of TNF-a induced by AMI could contribute to the onset of ventricular arrhythmias.

Recombinant human Flt3 ligand exerts both direct and indirect effects on hematopoiesis

OBJECTIVE: To investigate the direct effects of the Flt3 ligand (FL) on hematopoiesis, such as the stimulation of the formation of hematopoietic colonies and the proliferation of dendritic cells, as well as the indirect stimulation of hematopoiesis, especially via the proliferation of endothelial cells. METHODS: Mononuclear cells from human cord blood were plated in methylcellulose medium containing different cytokines to induce hematopoietic colony formation. Dendritic cells (DCs) were induced from the mononuclear cells with a cytokine cocktail with or without recombinant human soluble FL (rhFL; 100 ng/ml). The Flt3 receptors on the surface of a human microvascular endothelial cell line (ECV) were analyzed by flow cytometry. The proliferation of ECV stimulated by rhFL was measured with the microculture tetrazolium assay. The levels of FL, IL-6, IL-8, G-CSF and GM-CSF in the supernatant of ECV cultures were measured by enzyme linked immunoabsorbent assay (ELISA). RESULTS: rhFL stimulates colony formation from cord blood when used as a sole stimulant. FL in combination with other cytokines increased colony formation significantly. The number of DCs was approximately 2.5 times higher when rhFL was used. rhFL stimulates the proliferation of ECV on which Flt3 receptors are expressed. Furthermore, ECV secretes FL, IL-6, IL-8, G-CSF and GM-CSF, which were augmented by tumor necrosis factor-alpha and rhFL. CONCLUSIONS: rhFL enhances hematopoietic colony formation and DC proliferation from human cord blood cells. FL not only stimulates the proliferation of ECV, but is also secreted by ECV. FL may exert direct and indirect effects on hematopoiesis.

重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗中毒性表皮坏死松解症的疗效及安全性

目的探讨重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(rhTNFR:Fc)治疗中毒性表皮坏死松解症(TEN)患者的临床疗效及安全性。方法回顾性选取2020年1月至2022年1月海南医学院第一附属医院TEN患者20例,均给予rhTNFR:Fc治疗。治疗21 d后,记录TEN患者临床疗效,比较治疗前与治疗后不同时段(治疗后7、14、21 d)的药疹面积和严重程度指数(DASI)评分[DASI评分平均值,50%DASI(DASI50)、75%DASI(DASI75)、90%DASI(DASI90)所占比例]、血清肿瘤坏死因子α(TNF-α)水平、体温下降时间、皮疹控制时间、住院时间及药物治疗的安全性。结果治疗21 d后,TEN患者中,显效18例(90.00%),有效2例(10.00%)。TEN患者治疗后7、14、21 d的DASI评分分别为(30.44±5.68)、(5.28±2.31)、(2.04±1.12)分,均明显低于治疗前[(52.34±7.45)分],差异均有统计学意义(P<0.05)。相较治疗前、治疗7 d、治疗14 d,治疗21 d后的DASI50(100.00%)、DASI75(100.00%)、DASI90(90.00%)的改善比率最高,差异均有统计学意义(P<0.05)。TEN患者治疗后7、14、21 d的血清TNF-α水平分别为(22.73±5.58)、(15.99±4.60)、(4.44±1.10)pg/mL,均低于治疗前[(33.63±17.36)pg/mL],差异均有统计学意义(P<0.05)。TEN患者体温下降时间为(2.49±0.81)d,皮疹控制时间为(5.19±1.90)d,住院时间为(11.92±4.20)d。治疗期间患者未出现终止治疗或失访,均未出现急性不良反应,随访期间病情未见复发,定期复查结果显示并无合并症、活动性肝炎与结核疾病等。结论rhTNFR:Fc作为治疗TEN疾病的药物其疗效随治疗时间延长而提高,可降低血清TNF-α水平与DASI评分,且安全性较高。

TNF-α抑制剂注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白/注射用依那西普致葡萄膜炎2例分析

目的探讨TNF-α抑制剂与葡萄膜炎发病的关系并分析TNF-α抑制剂诱发性葡萄膜炎的临床特点。方法回顾性分析2021年7月至2023年2月某院收治的2例使用TNF-α抑制剂注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白注射用依那西普后出现葡萄膜炎患者的临床特征并复习相关文献。结果2例患者葡萄膜炎发生时间分别在用药后2周和6周,其中前葡萄膜炎1例,前、中间葡萄膜炎1例,经对症治疗后均有好转。在持续生物制剂治疗过程中2例患者均有反复发作倾向。查阅文献发现目前引起葡萄膜炎的TNF-α抑制剂主要包括英夫利昔单抗、阿达木单抗等,多用于治疗类风湿性关节炎、肿瘤、强直性脊柱炎、眼内葡萄膜炎患者等。患者年龄区间在5~77岁,发病时间为用药后1周~4年。经系统治疗,停止免疫抑制剂后,绝大多数诱发性葡萄膜炎患者视力可恢复。结论TNF-α抑制剂可以诱发葡萄膜炎的发生,发病类型以前葡萄膜炎为主,且有复发倾向。及时诊疗后患者的视力预后较好。

病毒性脑膜炎患儿血清和脑脊液中IP-10和TNF-α的表达情况及临床意义

目的探讨肿瘤坏死因子-α(TNF-α)、重组人干扰素诱导蛋白-10(IP-10)在病毒性脑膜炎患儿血清和脑脊液中的表达情况及临床意义。方法选取2019年7月至2020年12月在邢台市人民医院儿三科因急性中枢神经系统感染住院治疗的100例患儿作为研究对象。以脑膜炎感染类型分为病毒性脑膜炎组(52例)、化脓性脑膜炎组(34例)、结核性脑膜炎组(14例)。采用酶联免疫吸附试验检测所有研究对象血清及脑脊液TNF-α、IP-10水平。采用Pearson相关分析病毒性脑膜炎患儿血清及脑脊液TNF-α水平与IP-10水平的相关性。绘制受试者工作特征(ROC)曲线评估血清及脑脊液TNF-α和IP-10对病毒性脑膜炎的诊断价值。结果结核性脑膜炎组血清及脑脊液TNF-α和IP-10水平均高于化脓性脑膜炎组与病毒性脑膜炎组,且化脓性脑膜炎组均高于病毒性脑膜炎组,差异均有统计学意义(P<0.05)。病毒性脑膜炎患儿血清中IP-10水平与TNF-α水平呈明显正相关(r=0.313,P<0.05)。脑脊液中TNF-α水平与IP-10水平呈明显正相关(r=0.455,P<0.05)。ROC曲线分析结果显示,血清IP-10、TNF-α单独诊断病毒性脑膜炎的曲线下面积(AUC)分别为0.887、0.898,均小于2项指标联合诊断病毒性脑膜炎的0.958(Z=2.010、2.048,P<0.05);脑脊液IP-10、TNF-α单独诊断病毒性脑膜炎的AUC分别为0.926、0.908,均小于2项指标联合诊断病毒性脑膜炎的0.964(Z=2.208、2.260,P<0.05)。结论血清及脑脊液TNF-α和IP-10水平在病毒性脑膜炎患儿中明显降低,2项指标联合检测对病毒性脑膜炎的诊断具有重要临床价值。

Inhibition of tumor necrosis factor-α reduces alveolar septal cell apoptosis in passive smoking rats

Background Recent studies have revealed that lung cell apoptosis plays an important role in pathogenesis of cigarette-induced chronic obstructive pulmonary disease （COPD）. Tumor necrosis factor alpha （TNF-α） is one of the most important cytokines which are involved in COPD. This study aimed at investigating the influence of its inhibitor, recombinant human necrosis factor-alpha receptor II：lgG Fc fusion protein （rhTNFR：Fc） on alveolar septal cell apoptosis in passive smoking rats. Methods Forty-eight rats were randomly divided into a normal control group, a passive smoking group, an rhTNFR：Fc intervention group and a sham intervention group. The passive smoking rats were treated by exposure to cigarette smoking daily for 80 days. After smoking for one month the rhTNFR：Fc intervention group was treated with rhTNFR：Fc by subcutaneous injection, the sham intervention group injected subcutaneously with a neutral preparation （normal saline 0.1 ml, manicol 0.8 ml, cane sugar 0.2 mg, Tris 0.024 mg as a control. Lung function was determined and the levels of TNF-a in serum and broncho-alveolar lavage fluid （BALF） were measured with enzyme-linked immunosorbnent assay （ELISA）. Lung tissue sections stained by hematoxylin and eosin （HE） were observed for study of morphological alternations. Mean linear intercept （MLI） and mean alveolar numbers （MAN） were measured and the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling （TUNEL） method was carried out to determine the percentage of positive cells and distribution of apoptotic cells. Results Increased MLI and decreased MAN were found in the passive smoking group compared with both the normal control group and the rhTNFR：Fc intervention group （P〈0.05）. Forced expiratory volume in 0.3 second （FEVo.3）/forced vital capacity （FVC） and peak expiratory flow （PEF） were lower in the passive smoking group than that in the normal control group （P〈0.05）. Compared with the sham intervention group, FEVo.3/FVC and PEF increased in the rhTNFR：Fc intervention group （P〈0.05）. The levels of TNF-α in serum were higher in the passive smoking group than that in the normal control group （P〈0.05） and rhTNFR：Fc intervention group （P〈0.05）. Significant differences were found between the levels of TNF-α in the serum of the rhTNFR：Fc intervention group and sham intervention group （P〈0.05）. The levels of TNF-α in BALF were higher in the passive smoking group than that in the normal control group （P〈0.05）, but no significant differences of TNF-α levels in BALF were found between the passive smoking group and rhTNFR：Fc intervention group. The number of TUNEL positive cells in alveolar septa was significantly increased in the passive smoking group as compared with the normal control group and the rhTNFR：Fc intervention group （P〈0.05）. Conclusion This study provides preliminary evidence that rhTNFR：Fc may interfere with TNF-α and reduce alveolar septal apoptosis in smoking rats.

重组人Ⅱ型肿瘤坏死因子受体—抗体融合蛋白治疗类风湿关节炎的临床效果

目的 观察重组人Ⅱ型肿瘤坏死因子受体—抗体融合蛋白治疗类风湿关节炎的临床效果及对血清相关指标的影响。方法 选取2020年3月—2022年7月龙岩市第二医院血液风湿科收治的类风湿关节炎患者98例,依据随机抽签法分为联合抗风湿组和常规抗风湿组,每组49例。常规抗风湿组采取常规抗风湿治疗,联合抗风湿组在常规抗风湿组基础上使用注射用重组人Ⅱ型肿瘤坏死因子受体—抗体融合蛋白治疗,2组均持续治疗6个月。比较2组患者临床疗效,治疗前后症状改善情况、血清类风湿炎性指标[C反应蛋白(CRP)、红细胞沉降率(ESR)、类风湿因子(RF)、白介素-6(IL-6)],不良反应。结果 联合抗风湿组治疗总有效率为95.92%,高于常规抗风湿组81.63%(χ^(2)=5.018,P=0.025)。治疗6个月后,2组晨僵时间较治疗前缩短,压痛指数评分、疼痛指数评分较治疗前降低,且联合抗风湿组短/低于常规抗风湿组(P均<0.01);2组CRP、RF、IL-6水平较治疗前下降,ESR较治疗前缩小,且联合抗风湿组低/小于常规抗风湿组(P均<0.01)。联合抗风湿组不良反应总发生率为4.08%,低于常规抗风湿组的18.37%(χ^(2)=5.018,P=0.025)。结论 常规抗风湿治疗基础上采用重组人Ⅱ型肿瘤坏死因子受体—抗体融合蛋白治疗类风湿关节炎的疗效显著,利于临床症状、血清指标的改善,降低炎性因子水平及减少不良反应发生,促进病症好转。

新型重组人肿瘤坏死因子治疗非小细胞肺癌的多中心Ⅱ期临床随机试验

目的 观察比较国产新型重组人肿瘤坏死因子 (nrhTNF)加化疗和单纯化疗治疗非小细胞肺癌(NSCLC)的临床疗效和不良反应。方法 采用多中心、随机对照试验将 90例NSCLC患者随机分为试验组和对照组 ,两组各 45例患者。试验组在化疗的同时 ,分别在第 1～ 7天 ,第 11～ 17天肌肉注射nrhTNF 4×10 6U/m2 ,2 1天为一周 ,连用二个周期。对照组仅给予化疗 ,2 1天为一周期 ,连用二个周期。试验结束后比较试验组和对照组的有效率和不良反应。结果 试验组和对照组各有 3例患者因依从性原因出组 ,各有 42例可供临床疗效分析和不良反应分析。试验组有效率为 47.62 % ( 2 0 /4 2 ) ,对照组为 19.0 5 % ( 8/4 2 ) (P =0 .0 0 2 )。试验组治疗后KPS评分为 85 .0 2± 10 .74,对照组为 81.3 5± 9.63 (P =0 .0 3 8)。试验组和对照组Ⅲ+Ⅳ度不良反应无显著差异 (P >0 .0 5 )。与nrhTNF有关的不良反应主要有轻度发热、感冒样症状 ,注射局部疼痛 ,注射局部红肿硬结 ,均不需作特殊处理 ,治疗结束后均能自行消失。结论 国产nrhTNF联合化疗药物治疗NSCLC能显著提高化疗的有效率 ,改善患者的生活质量。nrhTNF临床应用安全、有效 ,不良反应轻微 。

应用基因工程方法制备新型重组人肿瘤坏死因子-α

目的 应用基因工程技术 ,制备一种新型的重组人肿瘤坏死因子 α (novelrecombinanthumantumornecrosisfactor α ,nrhTNF α) ,并对其生物学活性、理化性质进行鉴定 ,为进入临床前研究提供基础。方法 应用PCR技术 ,将hTNF α基因的 5′端 17个氨基酸的编码序列删除 ,基因中Pro8Ser9Asp10 的编码序列用Arg Lys Arg的编码序列取代 ,同时Leu157的密码子被Phe的密码子所取代。将hTNF α突变基因 ,插入原核高效表达载体pBV2 2 0中 ,构建高表达工程菌株。纯化表达产物 ,对连续 3批制备的新型rhTNF α,按人用《重组DNA制品质量控制要点》检定要求进行鉴定。结果DNA序列分析和蛋白质N末端、C末端部分氨基酸序列分析表明 ,nrhTNF α与天然的hTNF α相比较 ,N末端缺失了 7个氨基酸 ,13位氨基酸为Arg Lys Arg ,其后为天然hTNF α 11位以后的氨基酸。 15 7位Leu的密码子被Phe的密码子所取代。产物表达量占菌体蛋白的 6 7.4 %。经 (NH4) 2 SO4沉淀、Q SepharoseF .F .及S SepharoseF .F .柱层析分离纯化后 ,产品的纯度达 99% ,比活性达 1× 10 9IU/mg蛋白。结论成功地制备了nrhTNF ,对连续 3批制备的nrhTNF α按人用《重组DNA制品质量控制要点》检定要求进行鉴定 。

重组改构人肿瘤坏死因子对小细胞肺癌化疗的干预

目的：对比研究国产新药重组改构人肿瘤坏死因子（rmhTNF）加化学治疗和单纯化学治疗人小细胞肺癌（SCLC）的临床疗效和安全性。方法：采用随机对照试验，试验组15例．对照组17例。对照组仅给予EP方案化疗，而试验组在EP方案化疗的同时，分别在第1～7天，第11～17天肌内注射rmh．TNF4×10^6U·m^-2，两组均以21d为一周期。连用两个周期。结果：试验组治疗有效率为80．0％（12／15），对照组为58．8％（10／17），疗后KPS评分两组分别为（78.2±9．7）和（72．1±9．5），试验组有效率和治疗后KPS评分改善情况均显著高于对照组（P〈0．05）。试验组和对照组均未见有严重的不良反应发生。结论：新型基因工程药物rmhTNF联合化疗治疗人SCLC的疗效显著优于单纯化疗，能明显改善SCLC患者的生活质量，且临床应用安全。

注射用重组改构人肿瘤坏死因子联合化疗药物治疗非小细胞肺癌的多中心Ⅲ期临床试验

目的 观察并比较国产注射用重组改构人肿瘤坏死因子 (rmhTNF)加化疗药物和单纯化疗治疗人非小细胞肺癌的临床疗效和不良反应。方法 采用多中心、随机对照试验将 2 0 0例人非小细胞肺癌患者随机分为试验组和对照组 ,试验组 15 0例 ,对照组 5 0例。对照组仅给予化疗 ,而试验组在化疗的同时 ,分别在第 1～ 7天 ,第 11～ 17天肌肉注射rmhTNF 4× 10 6U /m2 ,两组均以 2 1天为一周期 ,连用两个周期。试验结束后比较试验组和对照组的有效率和不良反应。结果 试验组有 5例 ,对照组有 3例患者因为依从性原因出组 ,其余患者可供临床疗效和不良反应分析。试验组有效率为 46.90 % ( 68/ 14 5 ) ,对照组为 17.0 2 % ( 8/ 47)(P =0 .0 0 1)。试验组治疗后KPS评分为 86.0 2± 9.74,对照组为 80 .14± 9.10 (P =0 .0 2 5 )。试验组和对照组Ⅲ +Ⅳ度不良反应发生率无显著性差异 (P >0 .0 5 )。与rmhTNF有关的不良反应主要有轻度发热、感冒样症状、注射局部疼痛、注射局部红肿硬结 ,均不需作特殊处理 ,治疗结束后均能自行消失。试验组和对照组均未见有严重肝肾功能、心电图异常 ,以及低血压等不良反应发生。结论 rmhTNF联合化疗药物治疗人非小细胞肺癌的疗效显著优于单纯化疗 ,rmhTNF能明显提高化疗药物的敏感性 ,改?

转基因蓝藻制备α型重组人肿瘤坏死因子衍生物

应用ＤＮＡ重组技术将ａ型重组人肿瘤坏死因子衍生物（ｒｅｃｏｍｂｉｎａｎｔｈｕｍａｎｔｕｍｏｒｎｅｃｒｏｓｉｓｆａｃｔｏｒａ，ｒｈＴＮＦａ）ｃＤＮＡ插到穿梭质粒ＰＤＣ－８上，构建成穿梭表达载体ＰＤＣ－ＴＮＦ，转入鱼腥藻ＰＣＣ－７１２２０中进行表达。

重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白递减联合沙利度胺递增治疗方案干预活动性强直性脊柱炎的1年评价

背景:肿瘤坏死因子拮抗剂(如益赛普、阿达木单抗等)是目前治疗活动期强直性脊柱炎的最佳选择,但此类药物价格昂贵,寻求有效价廉的替代方案势在必行。目的:探讨重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(益赛普)递减应用联合沙利度胺递增治疗活动性强直性脊柱炎的1年随访。方法:研究经宜宾市第二人民医院医学伦理委员会审核批准。86例活动期强直性脊柱炎患者随机分为对照组和联合组各43例,患者及家属对治疗方案均知情同意。2组患者均用益赛普皮下注射,均25mg/次:初始用药,2次/周,连用2个月;当病情达到临床缓解标准后,即将益赛普每隔2个月递减剂量:第3个月初由2次/周减至1次/周;第5个月初减至10d1次;第7个月初减至2周1次;第9个月初减至3周1次;第11个月初减至4周1次,此后不再减量,用至12月末。若每次减量使病情加重而达不到临床缓解标准,则将益赛普重新调回前一个剂量。联合组患者同时联用沙利度胺片睡前服用,1次/d。初始剂量25mg/d,连用2个月,以后每隔2个月剂量递增25mg/d,直到第7个月初达到100mg/d时不再增加。2组患者疗程为12个月。结果与结论:①对照组43例,完成12个月疗程38例;联合组43例,完成12个月疗程40例;②从治疗后第4个月末至第12个月末,联合组的基于C-反应蛋白强直性脊柱炎疾病活动度评分(ASDAS-CRP)评分均显著低于对照组(P<0.05或P<0.01);③联合组的20%改善程度(ASAS20)达标率和强直性脊柱炎疗效评价ASAS5/6达标率均高于对照组(P<0.05或P<0.01);④联合组的临床缓解维持率高于对照组(χ~2=8.527,P=0.003);⑤12个月内联合组每位患者益赛普总用药量低于对照组(t=2.932,P=0.004);⑥2组患者不良反应发生率比较差异无显著性意义(χ~2=0.174,P=0.677);⑦结果说明,益赛普递减联合沙利度胺递增治疗强直性脊柱炎12个月,在延长益赛普用药间隔的方案中,可取得较高的疾病缓解率或低疾病活动状态,沙利度胺联合益赛普并不增加药物的不良反应。

注射用重组改构人肿瘤坏死因子治疗恶性肿瘤Ⅲ期临床观察

目的 :评价注射用重组改构人肿瘤坏死因子 (rmhTNF)与化疗联合治疗恶性肿瘤的有效性及不良反应。方法 :共入选 5 2例患者 ,随机分为试验组 39例 ,对照组 13例 ,试验组用rmhTNh 4 0 0万u·m-2 ,im ,d1～ 7,d11～ 17,同时联合应用化疗药物 ,2 1d为 1个周期 ,连用 2个周期 ;对照组联合化疗方案同实验组 ,但不加用rmhTNh。结果 :4 5例患者可评价疗效。试验组 33例中有效率为 36 36 % (12 /33) ;对照组有效率为 8 33% (1/12 )。试验组有效率高于对照组 ,但两组之间无统计学差异 (P =0 0 70 )。不同病种疗效分析显示试验组肺癌的有效率 4 4 4 4 % (8/18)高于对照组 10 % (1/10 ) ,而试验组 3例头颈部肿瘤患者均有效。与rmhTNh有关的不良反应发生率为 72 73% (2 4 /33) ,主要为轻度注射部位疼痛 72 73% (2 4 /33) ,红肿硬结 4 5 4 5 % (15 /33) ,少数患者出现发热 ,感冒样症状。结论 :rmhTNh与化疗药物联合应用治疗恶性肿瘤 ,显示对肺癌、头颈部肿瘤有较好的疗效 ,且毒性反应较轻。

重组改构人肿瘤坏死因子对肺腺癌致恶性胸腔积液封胸治疗的临床疗效分析

目的恶性胸腔积液（malignant pleural effusion,MPE）严重危害晚期肺癌患者生存质量,目前对其尚无理想治疗方法。文中回顾性分析重组改构人肿瘤坏死因子（recombinant human mutant tumor necrosis factor-alpha,rhu-TNF）治疗肺腺癌所致MPE的临床疗效与不良反应。方法回顾性收集2013年3月至2014年7月南京军区南京总医院呼吸与危重症医学科确诊的肺腺癌所致恶性胸膜腔积液患者70例,常规胸腔积液引流后,根据3~4万单位/kg分别以200万单位和300万单位剂量行胸腔内注射rhu-TNF,观察其疗效及不良反应。结果 200万单位和300万单患者有效率分别为75.68%和87.88%,差异无统计学意义（P=0.23）。注药前使用地塞米松的患者不良反应比不使用者明显减轻,差异有统计学意义（P=0.021）,但地塞米松的使用对rhu-TNF的疗效无影响（P=0.486）。结论 rhu-TNF是治疗肺腺癌所致MPE的高效、安全药物。地塞米松可减轻患者不良反应且不影响rhu-TNF疗效。